'; if ($HTTP_POST_VARS['lastname'] == '' ) $error = 'Last Name
'; if ($HTTP_POST_VARS['email'] == '' ) $error = 'Email
'; if ($HTTP_POST_VARS['details'] == '' ) $error = 'Details
'; if ($error=='') { $Ato = "patientcare@primedica.ca"; $Afrom = $HTTP_POST_VARS['email']; $Asubject = "Primedica - Contact form"; $Amessage = ' First Name : '. $HTTP_POST_VARS['firstname'] .'
Last Name : '. $HTTP_POST_VARS['lastname'] .'
Address : '. $HTTP_POST_VARS['address'] .'
State/Province : '. $HTTP_POST_VARS['state'] .'
Postal/Zip : '. $HTTP_POST_VARS['zip'] .'
Phone : '. $HTTP_POST_VARS['phone'] .'
Fax : '. $HTTP_POST_VARS['fax'] .'
E-Mail Address: '. $HTTP_POST_VARS['email'] .'
Details: '. $HTTP_POST_VARS['details'] .' '; $Aheaders = "From: $Afrom\r\n"; $Aheaders .= "Content-type: text/html\r\n"; $Asuccess = mail($Ato, $Asubject, $Amessage, $Aheaders); } } $page_header_image_text=' '; // Text on the header image $header_image = "contact2.jpg"; // Header Image $selected_top_menu_option = "contact"; // Display the selected option on the top menu $page_title = "Delbrook Surgical Centre"; require('template/header.php') ; //------------------------------------------------- ?>
Contact Us

Thank you

Your request has been mailed to custmer care.

We typically respond within 24hrs monday through friday.

ERROR: Please, specify your:

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Thank you."; } ?>
If you'd like to know more about Delbrook Surgical Centre, we will do our best to answer any questions you may have. There will be no pressure or obligation, and all correspondence will be kept strictly confidential.

Address
107 - 3711 Delbrook Ave.
North Vancouver, British Columbia
Canada V7N 3Z4

Toll Free: 1-888-985-7488
Telephone: 604-985-7488
Fax: 604-985-7470

e-mail: info@delbrooksurgical.com




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